(1/41) Does the liberalisation of abortion laws increase the number of abortions? The case study of Spain.

BACKGROUND: Over the course of the 1980s a public debate on abortion took place in Spain culminating in a more permissive social climate and, in 1985, the partial decriminalisation of abortion. Before this, women were forced to abort illegally or abroad in countries which had decriminalised abortions. The aim of this study is to present jointly the evolution of abortions in Spanish women in England and Wales between 1974 and 1995, The Netherlands between 1980 and 1995 and Spain since the start of the register in 1987 through to 1995 and to compare trends both before and after the law in Spain. METHODS: Incidence rates were calculated in each of the countries studied and the slopes of the curves for 1974-1984 and 1987-1995 were compared. Data were obtained from reports published by the offices of abortion surveillance in England and Wales, The Netherlands and Spain. RESULTS: The rates increased constantly throughout the study period. From 1974 to 1985, a total of 204,736 Spanish women aborted in England and Wales and The Netherlands. After the law was passed, 34,895 Spanish women had abortions in those countries over the period 1986-1995. During 1987-1995, 340,214 Spanish women terminated their pregnancies in Spain. The regression coefficients before and after the passing of the law were beta = 0.3538 (0.307-0.400) and beta = 0.319 (0.243-0.394) respectively; no difference was observed. CONCLUSIONS: During the study period a significant proportion of reproductive-aged Spanish women had abortions in England and Wales and The Netherlands. Decriminalisation has had no observed effect on the trends in abortion, but rather it has benefited Spanish women by making abortion available locally and, therefore, reducing the inequalities implied by lack of access to proper health care services. These data demonstrate the impact of the liberalisation of abortion on the trends of procedures performed in other countries.  (+info)

(2/41) Reports from the Faculty of Family Planning and Reproductive Health Care AGM, May 2002. Assessing the quality of information leaflets about abortion methods in England and Wales.

This study assessed the quality of written information about abortion methods provided by clinics in England and Wales. Forty-four sets of leaflets were collected. The average leaflet was found to provide only half the possible information about benefits, risks and general procedures. Only half of the leaflets were of standard readability and accessible by 83% of the British population. Therefore, it seems unlikely that most women in England and Wales are in a position to make an informed decision about abortion method.  (+info)

(3/41) Evaluation of near patient testing for Chlamydia trachomatis in a pregnancy termination service.

AIM: To identify and evaluate advantages and disadvantages of a near patient test (NPT) for Chlamydia trachomatis, using Clearview Chlamydia MF (Unipath Ltd) in a British Pregnancy Advisory Service (BPAS) clinic. METHOD: The improved Clearview Chlamydia MF test was used to test endocervical swabs from 400 women attending BPAS clinic for termination of pregnancy. The results were compared with Ligase Chain Reaction (LCR), using Polymerase Chain Reaction (PCR) as the arbiter. RESULTS: Twenty-seven women tested positive by Clearview Chlamydia MF (24 confirmed by LCR) and 32 by LCR. COMMENT: NPT has potential advantages in specific situations where a quick result is required for optimal management of those testing positive. However, the current technology available for detection of Chlamydial infection results in time constraints, which limited its benefits in this study, where there was a high throughput of clients. A significant number of cases were missed by Clearview Chlamydia MF, though the sensitivity found is within the ranges reported for various enzyme immunoassays (EIA) - currently the most commonly used testing method. The study confirmed the high positivity in those attending for termination, especially in under 25-year-olds.  (+info)

(4/41) Pregnancy counselling clinic: a questionnaire survey of intimate partner abuse.

CONTEXT: Intimate partner abuse has a significant and detrimental impact on the mental and physical health of a woman. Physical abuse is often associated with sexual abuse. OBJECTIVE: To examine the prevalence and nature of physical and sexual partner abuse experienced by women who request a termination of pregnancy (TOP). DESIGN: Quantitative data collection using an anonymous, self-completed questionnaire. SETTING: A pregnancy counselling clinic located within a large district general hospital in the north west of England. PARTICIPANTS: A sample of 312 women attending the clinic. RESULTS: Three hundred and twelve questionnaires were returned (96.7% response rate). The prevalence rate of intimate partner abuse at some stage in the woman's life was 35.1%; 19.5% had experienced actual physical abuse in the past year; and 3.7% had experienced forced sexual intercourse in the past year. Of the latter, in over half of the cases, this may have resulted in the current pregnancy. A total of 6.6% of women in this study are currently living in fear. DISCUSSION: The anonymity of the survey and the method of implementation encouraged an excellent response rate. The prevalence of physical abuse was higher than that reported in previous studies, however the prevalence of sexual abuse was lower. Up to 2% of requests for TOP could have been due to recent forced sexual intercourse. CONCLUSIONS: Many women requesting a TOP have been, or still are, in violent relationships. Some women may attend with an unwanted conception following sexual assault by their current or previous intimate partner.  (+info)

(5/41) Characteristics of women undergoing repeat induced abortion.

BACKGROUND: Although repeat induced abortion is common, data concerning characteristics of women undergoing this procedure are lacking. We conducted this study to identify the characteristics, including history of physical abuse by a male partner and history of sexual abuse, of women who present for repeat induced abortion. METHODS: We surveyed a consecutive series of women presenting for initial or repeat pregnancy termination to a regional provider of abortion services for a wide geographic area in southwestern Ontario between August 1998 and May 1999. Self-reported demographic characteristics, attitudes and practices regarding contraception, history of relationship violence, history of sexual abuse or coercion, and related variables were assessed as potential correlates of repeat induced abortion. We used chi2 tests for linear trend to examine characteristics of women undergoing a first, second, or third or subsequent abortion. We analyzed significant correlates of repeat abortion using stepwise multivariate multinomial logistic regression to identify factors uniquely associated with repeat abortion. RESULTS: Of the 1221 women approached, 1145 (93.8%) consented to participate. Data regarding first versus repeat abortion were available for 1127 women. A total of 68.2%, 23.1% and 8.7% of the women were seeking a first, second, or third or subsequent abortion respectively. Adjusted odds ratios for undergoing repeat versus a first abortion increased significantly with increased age (second abortion: 1.08, 95% confidence interval [CI] 1.04-1.09; third or subsequent abortion: 1.11, 95% CI 1.07-1.15), oral contraceptive use at the time of conception (second abortion: 2.17, 95% CI 1.52-3.09; third or subsequent abortion: 2.60, 95% CI 1.51-4.46), history of physical abuse by a male partner (second abortion: 2.04, 95% CI 1.39-3.01; third or subsequent abortion: 2.78, 95% CI 1.62-4.79), history of sexual abuse or violence (second abortion: 1.58, 95% CI 1.11-2.25; third or subsequent abortion: 2.53, 95% CI 1.50-4.28), history of sexually transmitted disease (second abortion: 1.50, 95% CI 0.98-2.29; third or subsequent abortion: 2.26, 95% CI 1.28-4.02) and being born outside Canada (second abortion: 1.83, 95% CI 1.19-2.79; third or subsequent abortion: 1.75, 95% CI 0.90-3.41). INTERPRETATION: Among other factors, a history of physical or sexual abuse was associated with repeat induced abortion. Presentation for repeat abortion may be an important indication to screen for a current or past history of relationship violence and sexual abuse.  (+info)

(6/41) Awareness of emergency contraception.

OBJECTIVE: To study the level of awareness and use of emergency contraception (EC) in women attending a pregnancy termination clinic. METHOD: A questionnaire was handed to all women attending the clinic for termination of pregnancy and related advice during the month of February 2003. Completed questionnaires were collected before the women left the clinic and the data analysed. RESULTS: A total of 78 women received the questionnaire and all except two were returned. Fifty-nine (78%) women were familiar with EC. Sixty percent of women felt that EC was easily accessible, but only 37% of them had ever used it. However, 90% of the women questioned would consider using EC in the future. CONCLUSION: Despite the level of awareness of EC in Fife being quite good, EC is underused for many reasons.  (+info)

(7/41) Does dedicated pre-abortion contraception counselling help to improve post-abortion contraception uptake?

OBJECTIVE: Many studies have shown a disappointing periabortion contraceptive uptake. This study investigated whether the provision of dedicated and targeted contraception counselling at the pre-abortion assessment visit can improve the post-abortion contraception uptake. METHODS: The study comprised a 3-month prospective reaudit of the abortion clinic. RESULTS: Of the 104 women seen during the re-audit period, 96% received post-abortion contraception. The majority (73%) of the women chose and received one of the less user-dependent contraceptive methods such as intrauterine contraceptive devices, the intrauterine contraceptive system, the progestogen injectable and subdermal implants. CONCLUSION: It was found that the provision of targeted contraception counselling by a dedicated team during the pre-abortion assessment visit can dramatically improve post-abortion contraception uptake.  (+info)

(8/41) Referral to a National Health Service-funded abortion clinic.

OBJECTIVE: To investigate the referral process from two Primary Care Trusts to a National Health Service-funded abortion clinic in the North West of England. METHODS: The study comprised a survey of all clinic attendees from within the study area during a 6-month period. All attending women were asked to complete an anonymous questionnaire. A total of 202 questionnaires were given out and 143 were returned completed (a 71% response rate). RESULTS: At least 90% of the women were referred directly from the first health professional they consulted to the abortion clinic. Five percent of the women were either referred to another health professional or not referred anywhere. Twelve percent of the women had to wait longer than the 3 weeks recommended by the Royal College of Obstetricians and Gynaecologists guideline. In a minority of cases this wait extended up to 7 weeks. However, most women were satisfied with the length of wait, the health professional they consulted with and, in particular, the care they received at the abortion clinic itself. CONCLUSIONS: In a minority of cases the referral system failed to meet the guidelines and recommendations made by professional bodies. Changes are necessary to ensure that all women receive a prompt and efficient referral to ensure that their procedure occurs at the earliest possible gestation.  (+info)

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